St. Jerome Regional CYO Registration
Please complete the following registration form for each child you wish to have participate in the St. Jerome Regional Catholic Youth Organization for the 2018-2019 season.  Please including the information as noted for each field.  In addition, a completed medical waiver and multimedia release form must be submitted prior to participation (form can be found on
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Student Last Name *
Student First Name *
Street Address *
City *
State *
Zip *
Birthdate *
Age *
Gender *
Grade *
Parish *
Parent/Guardian Name(s) *
Parent/Guardian Name(s) *
Address (if different from above)
Primary Phone Number *
Secondary Phone Number (please specify if it is a cell phone) *
Email *
Registration fee is $10 per sport
The registration fee will be used to cover the cost of team supplies and officials where necessary.  For 2018-2019 the fee is $10 per sport, per student.  Fee will be collected at the organizational meeting/practice for each sport.  Fees are non-refundable.
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